EMS Week 2020: Reflecting while we celebrate

During this week of celebrating who we are, we also need to recognize who we are not – superheroes unaffected by the events surrounding us


By Art Hsieh

National EMS Week is a time to be recognized for what we do – protecting the health of our communities by providing quality, compassionate care for those in their times of need. This year has been especially poignant as the global COVID-19 pandemic hit America's shores, causing major societal disruption and exposing field care providers to a potentially life-threatening hazard.

In turn, EMS systems have responded to the crisis by implementing novel protocols that keep non-urgent patients in their homes, coming up with innovative ways to treat infected patients who are seriously ill, and making countless phone calls and emails trying to secure precious personal protective equipment. Moreover, the increasing integration of EMS with public health will yield community health dividends far beyond this crisis.

FDNY paramedic Elizabeth Bonilla center wipes a tear from her eye while wearing personal protective equipment due to COVID-19 concerns after an emergency call, Wednesday, April 15, 2020, in the Bronx borough of New York. (AP Photo/John Minchillo)
FDNY paramedic Elizabeth Bonilla center wipes a tear from her eye while wearing personal protective equipment due to COVID-19 concerns after an emergency call, Wednesday, April 15, 2020, in the Bronx borough of New York. (AP Photo/John Minchillo)

Coping with cumulative stress

Beyond the headlines though, there is much more to the story. In hot spot areas, EMS workers are reporting increased levels of stress at work. The daily effort to maintain strict protection protocols, with the constant fear of becoming infected and bringing the disease home to family and friends, has been going on for months. Furthermore, there is no end in sight, no finish line to cross. This is our new normal. There are many experts who are projecting that the next pandemic wave will be worse than now.

Many of us are also seeing a rising level of deaths occurring in the field. It seems like this is correlated with the overall drop in call volume that many systems have reported. One coworker recently related that he had been involved in several cardiac arrests in the past two weeks. Prior to COVID-19, he might see one once a month or so. Many of these calls, and subsequent deaths were unexpected, and likely related to the reluctance of patients to seek emergency department care during this time of uncertainty.

This cumulative stress is part and parcel of the professional EMS provider's life. Dealing with pain and suffering on an everyday basis can cast shadows over even the most optimistic provider outlook on life. I suspect that many of us are feeling uneasy about our work, even as we learn more about how to manage this epidemic. This can be unsettling, even to the point of triggering those who are experiencing PTSD. I worry about provider suicide.

Our industry has been slowly waking to the emotional toll it exacts from its providers. National efforts like the Code Green Campaign have worked to spread information about provider mental health. Changes in the next EMS Education Standards will include explicit language regarding recognition and management of acute and chronic stress. Local organizations such as First Responder Resiliency are working with agencies to integrate mental wellness techniques into initial and continuing education for EMS and other public safety providers.

Building resiliency: taking care of each other

Beyond these initiatives are the actions we can take as fellow professionals. We are our brothers' and sisters' keepers. Who else can better understand what we see and feel in our daily line of work? Sometimes, we hesitate to reach out, feeling that somehow it's not our place in intrude on another's privacy. Nothing could be further from the truth. Many providers will relate that when life becomes overbearing, asking for help becomes a daunting effort. It's exactly during those times when a lifeline that is thrown to them is much desired and appreciated.

Not sure how to start the conversation? A simple "How are you doing today?" might be the start. Following up with "I'm here to listen and support you" shows that you care. Hearing that might be a shock to the individual, but it may be what they need to think about what's happening.  If someone opens up, don't automatically try to problem solve. Just listen and provide support. Most agencies have referral ability to employee assistance programs (EAPs) and professional help. Increasingly, EAPs are taking the form of peer support that helps to build trust for those in need.

During this week of celebrating who we are, we also need to turn to each other and recognize who we are not – superheroes who are unaffected by the events surrounding us, not just today, but every day. Taking care of ourselves gives us the ability to better take care of our communities.

Additional resources for mental health, resiliency

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